I'm the author of the new book, “Pound Foolish: Exposing the Dark Side of the Personal Finance Industry,” which was published by Penguin’s Portfolio imprint in January of 2013. I like to write and report on subjects where life meets money: that can be personal finance, parenting, women's issues, politics, education or career advice. Yes, I'm capable of merging them all in a single post. My goal is to surprise you, provoke you, and make you see the world in a different way. My last book was on office romance and why it works. Really. Want to get in touch? Give a holler at helaine.olen@gmail.com or follow me on Twitter @helaineolen.

How Much is that Hip Replacement in the Hospital?

Here’s a fun fact for the week of the Westminster Kennel Club dog show: you are much more likely to get an answer to the question “How much is a hip for that doggy in the window?” than to “How much is that hip in the human hospital?”

A Golden Retriever at 12 years old with hip problems (Photo credit: Wikipedia)

Or at least that’s one conclusion you can draw from a paper published earlier this week by JAMA Internal Medicine. As part of a study to determine medical costs, a team of researchers called more than one hundred hospitals across the United States. Their mission: to establish the price of a hip replacement for their mythical 62-year-old uninsured grandma.

The results? Let’s just say grandma’s grandchild would have to be a heck of a bargain hunter to get to the bottom of this mess. Less than twenty percent of the medical institutions surveyed were able to give a full-on estimate for faux-grandma’s hip procedure. When researchers contacted hospitals and doctors separately, they were able to get that number up to sixty percent.

As for the quotes themselves, they ran the gamut from $11,000 to $125,000 for the exact same hip procedure. The estimated tabs did not correlate with the quality of the hospitals. One institution judged one of the nation’s top orthopedic hospitals by U.S. News and World Report offered to do grandma’s hip for what sounds like the bargain price of $12,500 while one not-rated medical complex said they would bill just under $126,000 for the same procedure.

Moreover, researchers had to demonstrate the perseverance of Sisyphus to get the pricing information, something it seems highly unlikely very many real-life consumers could pull off successfully. As they put it:

Our calls to hospitals were often greeted by uncertainty and confusion by the hospital representatives about how to assist us. We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit.

For years, free market advocates have argued that one of the reasons for runaway medical spending is that consumers don’t have enough skin in the game. If they have high deductible policies, higher co-pays and health savings accounts, the thinking went, would-be patients would make sure to compare costs between doctors, hospitals and other such providers.

This study gives lie to that assertion. Never mind the fact that someone who suspects they might be having a heart attack isn’t exactly in a position to call five nearby emergency rooms before deciding where to get things checked out. It turns out that even if our hypothetical heart attack victim were able to run price checks on emergency room EKG offerings, he or she would be highly unlikely to get a straight answer.

In fact, there are so many conclusions one can draw from this paper, it is hard to know where to start. One could point to the ridiculousness of expecting consumers to comparison shop when practitioners can’t or won’t give them the information. One might ask why it is even legal to charge a consumer $125,000 for a procedure that Medicare and private insurance rarely pay more than $25,000 for. One could also ask what sort of insurance policies the people who expect others to comparison shop for medical services have, and if they have ever actually had to do medical price checking themselves.

Or, you could just give up and decide to get a dog. If your new pet does need hip surgery, it’s likely going to be quite easy indeed to determine the bill in advance. You won’t even need to make a phone call. Some outfits like the OhioState Veterinary Medical Center and ColoradoCanine Orthopedics list their estimated prices for Fido’s new joint online.

If you are wondering, the cost of a replacement hip for that doggy in the window is likely to be around $5,000.

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